Abstract
BackgroundIncreasing numbers of older individuals opt to spend extended time abroad each year for lifestyle, health, and financial reasons. This practice is known as international retirement migration, and it is particularly popular among retirees in Global North countries such as Canada. Despite the popularity of international retirement migration, very little is known about how and why health care is accessed while abroad, nor the opportunities and challenges posed for destination hospitals. In this article we focus on addressing the latter knowledge gap.MethodsThis qualitative case study is focused on the only hospital in Yuma, Arizona – a popular destination for Canadian retirement migrants in the United States. We conducted focus groups with workers at this hospital to explore their experiences of treating this transnational patient group. Twenty-seven people participated in three, 90-min focus groups: twelve nurses, six physicians, and nine administrators. Thematic analysis of the focus group transcripts was conducted using a triangulated approach.ResultsParticipants identified three care environments: practice, transnational, and community. Each environment presents specific opportunities and challenges pertaining to treating Canadian retirement migrants. Important opportunities include the creation of a strong and diverse seasonal workforce in the hospital, new transnational paths of communication and information sharing for physicians and health administrators, and informal care networks that support formal health care services within and beyond the hospital. These opportunities are balanced out by billing, practical, administrative, and lifestyle-related challenges which add complexity to treating this group of transnational patients.ConclusionCanadians represent a significant group of patients treated in Yuma, Arizona. This is contrary to long-standing, existing research that depicts older Canadians as being reluctant to access care while in the United States. Significant overlaps exist between the opportunities and challenges in the practice, transnational and community environments. More research is needed to better understand if these findings are similar to other destinations popular with Canadian international retirement migrants or if they are unique to Yuma, Arizona.
Highlights
Increasing numbers of older individuals opt to spend extended time abroad each year for lifestyle, health, and financial reasons
While we noted references of visits from friends and family to older Canadians in the hospital, the current study was focused on formal caregiving and did not explore informal caregiving in the international retirement migration context. Informal caregivers such as friends and family members encounter similar types of opportunities and challenges to those cited by the formal caregivers consulted in this study? Can informal caregivers play a role in mitigating or eliminating some of the challenges documented in this analysis and enhancing some of the opportunities? These are questions worth of exploration given the significant role that informal caregivers play in managing health and wellbeing among older populations [48,49,50,51]. In this exploratory qualitative analysis, we presented the findings of focus groups conducted with health care providers and administrators working at a regional hospital in Yuma, Arizona regarding their experiences of treating older Canadian retirement migrants who winter in this destination
Through thematic analysis we identified specific opportunities and challenges posed by treating this transnational patient population that transect three distinct environments encountered in the hospital-based care trajectory: the practice environment, the transnational environment, and the community environment
Summary
Increasing numbers of older individuals opt to spend extended time abroad each year for lifestyle, health, and financial reasons This practice is known as international retirement migration, and it is popular among retirees in Global North countries such as Canada. Previous research indicates the influx of older Canadian retirement migrants in the US is primarily to popular destinations in the southern states (e.g., Florida, Texas, Arizona, California) This seasonal migration of older Canadians can have many benefits for local economies, and recently proposed residency laws in the US are aimed at allowing Canadians to stay longer than 6 months and contribute more to the local economy [8]. While this increased seasonal demand is most clearly beneficial to the goods and service sectors and commercial retail outlets of destination economies, it is felt in allied sectors such as real estate and health care [4, 9]
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